Almond Supplementation Improves Acne Lesions and Skin Microbial Diversity in Adults with Mild to Moderate Acne Vulgaris

Objectives: This randomized, controlled, parallel-group study was conducted to evaluate the effectiveness of daily almond consumption on acne lesion counts, skin hydration, sebum production, and skin microflora composition in 18–35-year-old young adults with acne vulgaris in Mumbai, India. Methods: A defined amount of whole, unsalted almonds with skin (60 g) was provided to the experimental group (n = 36). The control group (n = 38) received isocaloric cereal-pulse-based snack varieties. The primary endpoints were changes in inflammatory, non-inflammatory, and total acne lesion counts after 20 weeks of supplementation. Secondary endpoints included changes in facial sebum, hydration levels, skin morphology and microflora, and selected biochemical parameters. Results: At week 20, the almond group showed greater reductions in total lesion counts (−22.2% vs. −9.8%), inflammatory lesion counts (−8.3% vs. +12%), and non-inflammatory lesion counts (−26.1% vs. −20.4%) than controls. Objective lesion volume, area, and height measures for both single and clustered acne decreased in the almond group (p ≤ 0.001). Microbial diversity increased, with the Shannon index (2.6 to 3.4 (p = 0.039) and the Chao1 richness index (266.9 → 835.2; p < 0.001) showing improvements at endline. Moreover, significant post-intervention changes in the psychosocial outcomes, such as the acne-related quality of life scores (p < 0.001) and anxiety symptoms (p = 0.016), were observed in the almond group. Conclusions: Daily almond consumption reduced acne lesion count and improved skin microbial diversity and acne-specific quality of life, highlighting its potential to complement standard acne treatments and support skin health.